The effect of preoperative chemotherapy treatment in surgically treated intrahepatic cholangiocarcinoma patients—A multi-institutional analysis

Stefan Buettner; Bas Groot Koerkamp; Aslam Ejaz; Florian E. Buisman; Yuhree Kim; Georgios Antonios Margonis; Sorin Alexandrescu; Hugo P. Marques; Jorge Lamelas; Luca Aldrighetti; T. Clark Gamblin; Shishir K. Maithel; Carlo Pulitano; Todd W. Bauer; Feng Shen; George A. Poultsides; J. Wallis Marsh; Jan N M IJzermans; Timothy M. Pawlik

doi:10.1002/jso.24524

The effect of preoperative chemotherapy treatment in surgically treated intrahepatic cholangiocarcinoma patients—A multi-institutional analysis

Stefan Buettner, Bas Groot Koerkamp, Aslam Ejaz, Florian E. Buisman, Yuhree Kim, Georgios Antonios Margonis, Sorin Alexandrescu, Hugo P. Marques, Jorge Lamelas, Luca Aldrighetti, T. Clark Gamblin, Shishir K. Maithel, Carlo Pulitano, Todd W. Bauer, Feng Shen, George A. Poultsides, J. Wallis Marsh, Jan N M IJzermans, Timothy M. Pawlik

School of Medicine

Research output: Contribution to journal › Article › peer-review

21 Scopus citations

Abstract

INTRODUCTION: While preoperative chemotherapy (pCT) is utilized in many intra-abdominal cancers, the use of pCT among patients with intrahepatic cholangiocarcinoma (ICC) remains ill defined. As such, the objective of the current study was to examine the impact of pCT among patients undergoing curative-intent resection for ICC. METHODS: Patients who underwent hepatectomy for ICC were identified from a multi-institutional international cohort. The association between pCT with peri-operative and long-term clinical outcomes was assessed. RESULTS: Of the 1 057 patients who were identified and met the inclusion criteria, 62 patients (5.9%) received pCT. These patients were noticed to have more advanced disease. Median OS (pCT:46.9 months vs no pCT:37.4 months; P = 0.900) and DFS (pCT: 34.1 months vs no pCT: 29.1 months; P = 0.909) were similar between the two groups. In a subgroup analysis of propensity-score matched patients, there was longer OS (pCT:46.9 months vs no pCT:29.4 months) and DFS (pCT:34.1 months vs no pCT:14.0 months); however this did not reach statistical significance (both P > 0.05). CONCLUSION: In conclusion, pCT utilization among patients with ICC was higher among patients with more advanced disease. Short-term post-operative outcomes were not affected by pCT use and receipt of pCT resulted in equivalent OS and DFS following curative-intent resection.

Original language	English (US)
Pages (from-to)	312-318
Number of pages	7
Journal	Journal of Surgical Oncology
Volume	115
Issue number	3
DOIs	https://doi.org/10.1002/jso.24524
State	Published - Mar 1 2017

Keywords

intrahepatic cholangiocarcinoma
preoperative chemotherapy
prognostic factors
risk factors
survival

ASJC Scopus subject areas

Surgery
Oncology

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10.1002/jso.24524

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Buettner, S., Koerkamp, B. G., Ejaz, A., Buisman, F. E., Kim, Y., Margonis, G. A., Alexandrescu, S., Marques, H. P., Lamelas, J., Aldrighetti, L., Gamblin, T. C., Maithel, S. K., Pulitano, C., Bauer, T. W., Shen, F., Poultsides, G. A., Marsh, J. W., IJzermans, J. N. M., & Pawlik, T. M. (2017). The effect of preoperative chemotherapy treatment in surgically treated intrahepatic cholangiocarcinoma patients—A multi-institutional analysis. Journal of Surgical Oncology, 115(3), 312-318. https://doi.org/10.1002/jso.24524

Buettner, S, Koerkamp, BG, Ejaz, A, Buisman, FE, Kim, Y, Margonis, GA, Alexandrescu, S, Marques, HP, Lamelas, J, Aldrighetti, L, Gamblin, TC, Maithel, SK, Pulitano, C, Bauer, TW, Shen, F, Poultsides, GA, Marsh, JW, IJzermans, JNM & Pawlik, TM 2017, 'The effect of preoperative chemotherapy treatment in surgically treated intrahepatic cholangiocarcinoma patients—A multi-institutional analysis', Journal of Surgical Oncology, vol. 115, no. 3, pp. 312-318. https://doi.org/10.1002/jso.24524

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title = "The effect of preoperative chemotherapy treatment in surgically treated intrahepatic cholangiocarcinoma patients—A multi-institutional analysis",

abstract = "INTRODUCTION: While preoperative chemotherapy (pCT) is utilized in many intra-abdominal cancers, the use of pCT among patients with intrahepatic cholangiocarcinoma (ICC) remains ill defined. As such, the objective of the current study was to examine the impact of pCT among patients undergoing curative-intent resection for ICC. METHODS: Patients who underwent hepatectomy for ICC were identified from a multi-institutional international cohort. The association between pCT with peri-operative and long-term clinical outcomes was assessed. RESULTS: Of the 1 057 patients who were identified and met the inclusion criteria, 62 patients (5.9%) received pCT. These patients were noticed to have more advanced disease. Median OS (pCT:46.9 months vs no pCT:37.4 months; P = 0.900) and DFS (pCT: 34.1 months vs no pCT: 29.1 months; P = 0.909) were similar between the two groups. In a subgroup analysis of propensity-score matched patients, there was longer OS (pCT:46.9 months vs no pCT:29.4 months) and DFS (pCT:34.1 months vs no pCT:14.0 months); however this did not reach statistical significance (both P > 0.05). CONCLUSION: In conclusion, pCT utilization among patients with ICC was higher among patients with more advanced disease. Short-term post-operative outcomes were not affected by pCT use and receipt of pCT resulted in equivalent OS and DFS following curative-intent resection.",

keywords = "intrahepatic cholangiocarcinoma, preoperative chemotherapy, prognostic factors, risk factors, survival",

author = "Stefan Buettner and Koerkamp, {Bas Groot} and Aslam Ejaz and Buisman, {Florian E.} and Yuhree Kim and Margonis, {Georgios Antonios} and Sorin Alexandrescu and Marques, {Hugo P.} and Jorge Lamelas and Luca Aldrighetti and Gamblin, {T. Clark} and Maithel, {Shishir K.} and Carlo Pulitano and Bauer, {Todd W.} and Feng Shen and Poultsides, {George A.} and Marsh, {J. Wallis} and IJzermans, {Jan N M} and Pawlik, {Timothy M.}",

year = "2017",

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doi = "10.1002/jso.24524",

language = "English (US)",

volume = "115",

pages = "312--318",

journal = "Journal of Surgical Oncology",

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T1 - The effect of preoperative chemotherapy treatment in surgically treated intrahepatic cholangiocarcinoma patients—A multi-institutional analysis

AU - Buettner, Stefan

AU - Koerkamp, Bas Groot

AU - Ejaz, Aslam

AU - Buisman, Florian E.

AU - Kim, Yuhree

AU - Margonis, Georgios Antonios

AU - Alexandrescu, Sorin

AU - Marques, Hugo P.

AU - Lamelas, Jorge

AU - Aldrighetti, Luca

AU - Gamblin, T. Clark

AU - Maithel, Shishir K.

AU - Pulitano, Carlo

AU - Bauer, Todd W.

AU - Shen, Feng

AU - Poultsides, George A.

AU - Marsh, J. Wallis

AU - IJzermans, Jan N M

AU - Pawlik, Timothy M.

PY - 2017/3/1

Y1 - 2017/3/1

N2 - INTRODUCTION: While preoperative chemotherapy (pCT) is utilized in many intra-abdominal cancers, the use of pCT among patients with intrahepatic cholangiocarcinoma (ICC) remains ill defined. As such, the objective of the current study was to examine the impact of pCT among patients undergoing curative-intent resection for ICC. METHODS: Patients who underwent hepatectomy for ICC were identified from a multi-institutional international cohort. The association between pCT with peri-operative and long-term clinical outcomes was assessed. RESULTS: Of the 1 057 patients who were identified and met the inclusion criteria, 62 patients (5.9%) received pCT. These patients were noticed to have more advanced disease. Median OS (pCT:46.9 months vs no pCT:37.4 months; P = 0.900) and DFS (pCT: 34.1 months vs no pCT: 29.1 months; P = 0.909) were similar between the two groups. In a subgroup analysis of propensity-score matched patients, there was longer OS (pCT:46.9 months vs no pCT:29.4 months) and DFS (pCT:34.1 months vs no pCT:14.0 months); however this did not reach statistical significance (both P > 0.05). CONCLUSION: In conclusion, pCT utilization among patients with ICC was higher among patients with more advanced disease. Short-term post-operative outcomes were not affected by pCT use and receipt of pCT resulted in equivalent OS and DFS following curative-intent resection.

AB - INTRODUCTION: While preoperative chemotherapy (pCT) is utilized in many intra-abdominal cancers, the use of pCT among patients with intrahepatic cholangiocarcinoma (ICC) remains ill defined. As such, the objective of the current study was to examine the impact of pCT among patients undergoing curative-intent resection for ICC. METHODS: Patients who underwent hepatectomy for ICC were identified from a multi-institutional international cohort. The association between pCT with peri-operative and long-term clinical outcomes was assessed. RESULTS: Of the 1 057 patients who were identified and met the inclusion criteria, 62 patients (5.9%) received pCT. These patients were noticed to have more advanced disease. Median OS (pCT:46.9 months vs no pCT:37.4 months; P = 0.900) and DFS (pCT: 34.1 months vs no pCT: 29.1 months; P = 0.909) were similar between the two groups. In a subgroup analysis of propensity-score matched patients, there was longer OS (pCT:46.9 months vs no pCT:29.4 months) and DFS (pCT:34.1 months vs no pCT:14.0 months); however this did not reach statistical significance (both P > 0.05). CONCLUSION: In conclusion, pCT utilization among patients with ICC was higher among patients with more advanced disease. Short-term post-operative outcomes were not affected by pCT use and receipt of pCT resulted in equivalent OS and DFS following curative-intent resection.

KW - intrahepatic cholangiocarcinoma

KW - preoperative chemotherapy

KW - prognostic factors

KW - risk factors

KW - survival

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The effect of preoperative chemotherapy treatment in surgically treated intrahepatic cholangiocarcinoma patients—A multi-institutional analysis

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